Active NPI
Paul Douglas Hauck, PHD.
- Clinical Child & Adolescent Psychologist
- Travis AFB, CA
National Provider Identifier
1033103619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- 6689
- Practice address
- 60MDG/Sgohh
101 Bodin Cir
Travis AFB, CA 94535 - Phone
- (707) 423-5174
- NPI assigned
- Sep 9, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | 6689 | CA | Primary |
Addresses
Primary practice location
60MDG/Sgohh
101 Bodin Cir
Travis AFB, CA 94535
Mailing address
5070 Adalis Dr
Elk Grove, CA 95758-6778
Phone (916) 392-9970
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6689 | CA | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1033103619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5070 ADALIS DR",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "957586778",
"telephone_number": "916-392-9970"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "60MDG/SGOHH",
"address_2": "101 BODIN CIR",
"city": "TRAVIS AFB",
"state": "CA",
"postal_code": "94535",
"telephone_number": "707-423-5174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAUCK",
"first_name": "PAUL",
"middle_name": "DOUGLAS",
"name_prefix": "Dr.",
"credential": "PHD.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "CA",
"license": "6689",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Travis AFB, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.